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1

What is positive likelihood ratio? How is it calculated?

LR+ = probability of a person who has the disease testing positive divided by the probability of a person who does not have the disease testing positive
LR+ = SE / (1-SP)

2

What is negative likelihood ratio? How is it calculated?

Probability of a person who has the disease having a negative test divided by the probability of a person who doesn't have the disease testing negative
LR- = (1- SE) / SP

3

How do you calculate PPV?

PPV = TP / TP + FP
Correspond to the probability of a positive test being associated with the disease
(Optimal value close to 1)

4

How is NPV calculated?

NPV = TN / FN
Correspond to the probability of a negative test being associated with the disease
(Optimal value close to 1)

5

How is calculated the NNT?

1/absolute risk reduction (i.e. difference in proportions between both groups)

6

List criteria to determine causality (8)

- Temporal relationship
- Biological plausability
- Strenght (large RR)
- Dose response
- Reversibility
- Consistency (repeatedly observed)
- Specificity (one cause, one effect)
- Analogy

7

Authorship guidelines (4 criteria)

1. Substantial contributions to the conception or design of the work
2. Drafting the work or revising it critically
3. Final approval of the version to be published
4. Agreement to be accountable for all aspect of the work
(all 4 must be present)

8

Name the 3 hallmarks of informed consent

1. Appropriate information
2. Decision-making capacity
3. Voluntary

9

In informed consent, what is considered appropriate information?

What is the disease, what are treatment options (and the option of no treatment), risks and benefits of each, and likely outcomes

10

What is a mature minor?

It is a minor who is able to understand his/her health condition, and can appreciate the consequences of different treatment options

11

Give 3 examples of situations where physician needs to break patient's confidentiality

1. Situation where patients or others face an imminent, severe danger
2. Suspicion of abuse or neglect of a minor
3. Patient affected with reportable infectious disease

12

Appropriate steps in case of medical error?

1. Give appropriate care to patient and plan next appropriate steps in care (include follow-up to a colleague if requested by family
2. Divulgation, with honesty and empathy
3. Document medical errors, divulgation, and steps taken
4. Participate in quality improvement activities to avoid re occurence of medical errors or near-misses

13

Describe SPIKES framework in disclosing bad news

S - Setting up the interview
P - Assess patient's Perception
I - Obtaining patient's Invitation
K - Giving Knowledge and information to patient and family
E - Addressing patient's emotions with empathy
S - Summary and strategy going forward